期刊
ALZHEIMERS & DEMENTIA
卷 11, 期 10, 页码 1191-1201出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jalz.2014.12.001
关键词
Alzheimer's disease; MCI; MRI; PET; Diagnostic criteria; Diagnostic accuracy
资金
- Swedish Research Council [05817]
- Strategic Research Program in Neuroscience at Karolinska Institutet
- Swedish Brain Power
- sottoprogetto finalizzato Strategico
- Programma Strategico, Ricerca Corrente Italian Ministry of Health [71, PS39]
- Fitness e Solidarieta' fund raising campaigns
Introduction: Proposed diagnostic criteria (international working group and National Institute on Aging and Alzheimer's Association) for Alzheimer's disease (AD) include markers of amyloidosis (abnormal cerebrospinal fluid [CSF] amyloid beta [A beta]42) and neurodegeneration (hippocampal atrophy, temporo-parietal hypometabolism on [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET), and abnormal CSF tau). We aim to compare the accuracy of these biomarkers, individually and in combination, in predicting AD among mild cognitive impairment (MCI) patients. Methods: In 73 MCI patients, followed to ascertain AD progression, markers were measured. Sensitivity and specificity, positive (LR+) and negative (LR-) likelihood ratios, and crude and adjusted hazard ratios were computed. Results: Twenty-nine MCI patients progressed and 44 remained stable. Positivity to any marker achieved the lowest LR- (0.0), whereas the combination A beta 42 plus FDG-PET achieved the highest LR+ (6.45). In a survival analysis, positivity to any marker was associated with 100% conversion rate, whereas negativity to all markers was associated with 100% stability. Discussion: The best criteria combined amyloidosis and neurodegeneration biomarkers, whereas the individual biomarker with the best performance was FDG-PET. (C) 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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